By the Blouin News Science & Health staff

Hyperandrogenism and the plight of the female athlete

by in Fitness & Wellbeing.

Getty Images

Getty Images

Last week the Court of Arbitration for Sports (CAS) determined that female athletes with high testosterone — a condition known as hyperandrogenism — would be allowed to compete against other women, and would no longer be required to undergo medical treatment to lower their naturally high testosterone levels. This occurred on the heels of the an investigation following the 2014 suspension of Indian sprinter, Dutee Chand. Chand was suspended amid complaints from competitors regarding her more “masculine” physique and allegations that she may not be a woman. This resulted in her suspension from competing under the International Association of Athletic Federations 2011 regulation.

The CAS found that there was not sufficient scientific evidence that the difference in testosterone levels among female competitors warranted any action by the committee.  In a critique published on July 13 by The American Journal on Bioethics, the authors stated that there was insufficient research to determine a normal level of testosterone among female athletes; furthermore, there is no research that concludes that testosterone levels are an accurate predictor of athletic performance.

This issue has been a long-standing, controversial one. Back in 2012, Katrina Karkazis, Ph.D, senior research scholar at Stanford’s Center for Biomedical Ethics wrote: “These new policies try to get around that complexity by singling out testosterone levels as the most important aspect of athletic advantage. But what causes athletic advantage is equally complex and cannot be reduced to testosterone levels.”

Dr. Karkazis is among a number of members of the international scientific and athletic community that are concerned with the implications of IAFF regulations and the group’s treatment of hyperandrogenous female athletes. David Epstein, the author of The Sports Gene, told Runner’s World that he read the report and is quoted as saying, “Given that sports bodies are trying to impose a binary result on non-binary human biology, they’re going to end up drawing an arbitrary line somewhere, and that’s okay with me…I’d just like to see them be open and honest about this. They should admit that they can’t be fair to everyone, because an arbitrary line is just that—arbitrary.”

In a testimony to the CAS, it was reported that 1 in 20,000 women have higher levels of testosterone like the kind seen in Dutee Chand. Among elite female athletes, testosterone is estimated to be up to 140 times greater than in the general public. It is widely believed that women have two X chromosomes while men have an X and a Y, yet there are a large number of chromosomal markers and that notion is not always true. It is uncommon, but the Y chromosome does exist in a small number of women. While Epstein concedes that sports bodies will inevitably make ‘arbitrary’ ruling on who can and cannot compete, he draws light to the lack of research and science to examine the complexity of the spectrum of gender in sports.

Spanish hurdler Maria Martinez-Patino, a high profile inter-sex athlete, was stripped of her 1986 national championship in the 60 meter hurdles because test results showed that she had XY chromosomes. Although her championship was eventually reinstated by the IAAF, she recalled the pain and embarrassment of the experience in published articles after the fact, noting that the psychological consequences of her experience were excruciating and the IAAF’s testing excessively invasive. The question here is: is such testing necessary?

The science shows that the human body is complex, and there is no research to prove that levels of testosterone in women or men are significant determiners of athletic ability. The science also states that there is a wide spectrum of levels of testosterone, chromosomal make-up and physical appearance among women. It’s about time for society to evolve alongside the science. For sports to be equal, a re-evaluation of the traditional ideas of gender and sex, who is or who isn’t male or female, and what they can and cannot do with their bodies is in order.